Mapping the Neurobiological Risks and Consequences of Alcohol Use in Adolescence and Across the Lifespan

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PROJECT SUMMARY/ABSTRACT Globally, 1.34 billion people consume alcohol in harmful amounts, with alcohol use accounting for 1.78 million deaths in 2020. Alcohol use often begins, and noticeably escalates, throughout adolescence. Incidence of alcohol use disorder (AUD) and related symptomatology follows a similar pattern, peaking between the ages of 18 and 20 years. As such, AUD has been described as a “developmental disorder” of young adulthood. While rates of problematic drinking are highest among young adults, recent years have seen large increases in problematic drinking among older adults, with corresponding increases in AUD and alcohol-related hospitalizations. The developmental processes contributing to alcohol use disorders (AUD) have long been recognised but there remain substantial gaps in our knowledge about the neurobiological predictors of “milestones” along the pathway to AUD, as well as the neurobiological consequences of alcohol use throughout adolescence into midlife and older age. Our overarching aim is to therefore uncover the neurobiological risks of adolescent alcohol use and distinguish these from the consequences of alcohol use in adolescence and across the lifespan. This will be done within a developmental framework and conducted with a focus on replicability and rigorous causal modelling. To address our aim, we need large-scale longitudinal assessments of alcohol use, capturing the peak period of adolescent risk, and incorporating comprehensive other substance use, behavioral, environmental, and imaging data. Data from the Adolescent Brain and Cognitive Development (ABCD) Study therefore provide an unprecedented opportunity to address our aim. To extend our examination of the consequences of alcohol use across the lifespan, we will combine (or harmonize) ABCD data with large-scale, high quality cohort data from different life stages and jointly analyze these data to establish the neurobiological predictors and consequences of alcohol use at key periods across the lifespan within a unified framework. This project represents innovation in its: 1) developmental approach to the relationship between alcohol use and neurobiology which focuses on adolescence but also extends across the lifespan into older adulthood; 2) harmonization of data across four landmark datasets across the lifespan; 3) methodological rigor focusing on the promotion of causal inference; 4) the application of neuroimaging and biostatistical techniques that are unique to the research team; and (5) focus on replicability and the open science framework, including preregistration of all analyses and publicly available code. Outcomes from this project will have the potential to provide novel neurobiological targets for medication development, as well as alcohol preventions and interventions informed by neuroscience. We will also take the first steps towards the establishment of a larger international consortium of longitudinal cohort studies focused on the impact of alcohol use on brain health across the lifespan.